Objective To evaluate the relevance of the macular hole index (MHI) and the visual outcomes of the idiopathic macular hole (IMH) after the retinal internal limiting membrane (ILM） peeling surgery.Methods Thirty IMH patients (30 eyes) undergoing vitrectomy and ILM peeling were included in this study. The IMH diagnosis was confirmed by best corrected visual acuity (BCVA), slit lamp microscope, indirect ophthalmoscope and optical coherence tomography (OCT). The central retinal thickness, the height and the base diameter of macular holes were measured by OCT. The MHI was the ratio of the height and the base diameter of macular holes. The patients were divided into two groups (MHIge;0.5 group and MHI＜0.5 group) according to the MHI.The post-surgery follow-up was three to 24 months with an average of 10 months. Spearman correlation analysis was performed between BCVA (pre and post-surgery), age, disease duration and MHI. The differences in BCVA after surgery between the two MHI groups was further evaluated by independent samplest-test for quantitative data.Results All the macular holes in 30 eyes closed after surgery, closure rate was 100%. Postoperative BCVA was correlated with MHI by Spearman analysis (r=0.852,P＜0.001), but not correlated with age (r=0.001, P=0.804) and disease course (r=-0.001,P=0.579). Postoperative BCVA was better in the MHIge;0.5 group (t=5.552,P＜0.001). Conclusions The postoperative visual outcome of IMH patients was correlated with the MHI. MHI can be used as a prognostic factor of postoperative visual outcomes for IMH patients.
Objective To evaluate the successful rate of surgical treatment of retinal detachment due to macular hole in high myopia, and to analyze the relative reasons. Methods Eleven eyes of 11 high myopic patients with retinal detachment due to macular hole underwent vitrectomy combined with the adjunct of 18% C3F88or silicone oil. Strict prone position was conducted at least 2 weeks postoperatively. Results Macular hole closed and retina reattached in 10 eyes. Visual acuity was increased in 10 eyes, and no change in 1 eye. Postoperative complications mainly included nuclear sclerosis of the lens(1 eye), intraocular pressure elevation (1 eye), fibrosis exudates (2 eyes)，and diplopia (1 eye). Conclusion The use of vitrectomy combined with the adjunct of 18% C3F8or silicone oil is a safe and effective method in treating retinal deta chment due to macular hole in high myopia. Preoperative careful examination of o cular fundus, rational surgical design, and better surgical expertise are basic factors in treating this disease. (Chin J Ocul Fundus Dis, 2001,17:90-92)
Purpose To assess the efficacy of pars plana vitrectomy,autologous platelet concentrate and gas tamponade for the treatment of full-thickness idiopathic macular holes. Methods The procedures consisted of pars plana vitrectomy with removal of posterior cortical vitreous，air-fluid exchange, instillation of autologous platelet concentrate onto the posterior pole and 20%～30%SF6 tamponade,were performed in treating 6 eyes of 6 patients with idiopathic macular holes. The patients were instructed to lie in a supine position for l hour after surgery,then adviced to remain in a facedown position for 2 weeks. Results Flattening of the surrounding retina and closure of the hole were achieved postoperatively in all the 6 affected eyes.Visual acuity improved two lines or more in 5 eyes (83.3%).Four eyes(66.7%)reached a postoperative visual acuity of 0.3 or more. Retinal detachment ocurred in one eye owing to peripheral new hole formation. Conclusion Pars plana vitrectomy, autologous platelet concentrate and gas tamponade for the treatment of full-thickness idiopathic macular holes are able to close macular hole and improve the visual acuity. (Chin J Ocul Fundus Dis,1998,14:14-15)
Purpose To observe the clinical features and visual acuity of the eyes with idiopathic macular holes. Methods We reviewed the clinical materials of 23eyes of 18 patients with idiopathic macular holes and the follow up results from 6 to 120 months. Results In the initial examinations of 22 eyes,the numbers of eyes with stagesⅠ-Ⅳ macular holes were5,4,10,3 eyes respectively,and funds fluorescein angiography showed there were focal transmission of choroidal fluorescein in 17 eyes (stagesⅡ～Ⅳ).Macular hole ocurred in one eyes during follow up.At the final examination of 23 eyes,the numbers of eyes with stages Ⅰ～Ⅳ macular holes were 2,2,9,8 eyes respectively .Full-thickness macular hole of 2 eyes closed naturally after posterior vitreous detachment.The time interval of the subjective visual loss on stage Ⅰ was 5-8 months,stageⅡ8-20 months,stageⅢ12-126 months ,and the average visual acuity on stageⅠwas 0.7,stage 0.55,stageⅢ0.08,and stage Ⅳ0.08 Conclusion Approximately 60% of impending (stage Ⅰ) hole progress to full thickness holes, the full thickness holes were usually enlarged and the visual acuity of affected eyes decreased as the natural course was prolonged . (Chin J Ocul Fundus Dis,1998,14:222-223)